Pandemic view from Dr Maurice Gueret: 'in the current crisis, surely the paracetamol limit could be reviewed'

Sharing thoughts on Leo, Boris and their respective management of the coronavirus crisis, Maurice Gueret suggests we relax the limits on paracetamol.

Leo's moment

Readers have asked me to write more about coronavirus. The truth of the matter is that Rude Health is written two-and-a-half weeks before publication. This pandemic has clearly shown that just a day can be a long time in healthcare. So bear in mind that I am writing this piece after a muted celebration of St Patrick. Leo, pictured, has stated that we are in the calm before the storm. He cannot promise to drive the virus from our shores. It's here. It's a fact. We just have to deal with it. I have been impressed with his stand-in performance since the country deselected him as Taoiseach. It may be a decision we regret. I suspect EU bigwigs may be looking for new leadership very soon. Europe has been poor on Covid-19. Headhunting agencies may be fighting each other to have Leo on their books. Our loss.

Bob-a-job

General practice and critical care are on the frontline against this pandemic. Both are neglected areas of healthcare, and less well-connected in the daily lobbying for slices of cake. General practice is still the bob-a-job part of our health service. Need proof? Look at the hurriedly negotiated fee of €30 a phone call for family doctors dealing with coronavirus worries, and €75 for a lung examination in surgery. Hired community hands, GPs continue to be paid like handymen in a crisis. With our chronic shortage of intensive-care beds, Ireland's ICU doctors are well practised in the business of shifting Father Dougal out to treat a more urgent Father Jack. But serious cases of Covid-19 demand ventilators, operated by teams of highly trained round-the-clock nurses, often for days on end. That is the pinch point, our deepest angst, and the one that has leaders looking so pessimistic. I find myself scanning the daily figures of other countries for crumbs of comfort. The number of positive test cases is probably less significant than the number of deaths. I'll be watching death rates in countries like Germany and the USA - they have five times as many critical-care beds per head as we have. And I'll be praying to St Patrick.

Last-gasp Boris

Across the water, World King Boris has the visage of a worried man. I try to record his daily afternoon press briefings on coronavirus. St Patrick didn't even get a mention on March 17 as Boris hit the hyperbole button on his thesaurus. He called on fellow citizens to get through the experience as quickly as possible by "sedulously, zealously, meticulously, scrupulously following the medical advice". Like Trump, he is all industry. Boris's cunning plan is to get domestic hoover and leaf-blowing companies to produce 30,000 new hospital ventilators within a month. Doctors and nurses who operate them were less than impressed when he nicknamed his endeavour Operation Last Gasp. Covid-19 could make or break Boris. If you need an entertaining read during lockdown, you could try his sister's new book. Rachel Johnson has published Rake's Progress, an account of trying to grow up in the Johnson household. The Johnsons were frequent users of casualty units as children. Boris's brother Leo would stuff baked beans up his nose. Another brother, Jo, turned a funny colour when he ate some mouldy fungus that was growing behind the washing machine. As he was being checked over by emergency doctors in UCH London, Rachel Johnson was an inpatient upstairs, having choked on eggshell when Boris told funny stories at breakfast. The bowels of their local hospital must have full filing cabinets marked 'J'.

Paracetamol limits

A small issue, but it's very inconvenient for families with more than one patient at home with a fever. Over the Border in Newry, you can walk into Tesco or Sainsbury's and buy two packets of 500mg-strength paracetamol, with 16 doses in each packet. That's 32 tablets. No more are allowed. Two packets cost about €2. The adult dose is up to four a day, and the general advice is not to use them for more than three days without having a word with your doctor. South of the Border, the most you can buy in a supermarket is one single packet of 12, which will usually cost more than two packs of 16 up North. These discrepancies on the one island for an important medicine have never been satisfactorily explained to me. I'm happy to wait. But in the current emergency, surely these limits could be reviewed, so that trips outside the house can be minimised.